INSTRUCTIONS FOR COMPLETING THE HENNEPIN COUNTY CONCILIATION COURT CLAIM FORM The following information is required to process your Conciliation Court Claim. If required information is not provided, your claim form and filing fee will be returned to you. 1. Enter plaintiff(s) name, street address, city, state, zip code and date of birth. (Please verify that city is correct). One name per box, even for married couples. Note: If more than two plaintiffs use Additional Litigant Form. 2. Enter defendant(s) name, street address, city, state and zip code. Include their telephone number if known. (Please verify that city is correct) If defendant’s mailing address is a PO Box, list the street address where they live in the text box for the claim to verify jurisdiction. One name per box, even for married couples. Note: If more than three defendants use Additional Litigant Form. 3. Enter the following information: • Amount owed ($7,500 maximum) • Filing Fee - $70.00 • Grand Total including filing fee • Date of Incident, event or transaction • Brief description– please use size 10 font or larger and only use the space provided in the text box. Keep your claim form to one page. 4. Sign the claim form and include your daytime phone number with area code. Your signature must be notarized. Failure to include all of the above will result in your documents being returned to you without being filed. Do not attach exhibits or other documents to the claim form. Please bring them to court on the day of your hearing. Mail or bring your claim form and $70.00 filing fee payable to “Hennepin County Conciliation Court” to: Conciliation Court 350 South 5th Street Room 306 – City Hall Minneapolis MN 55415-0926 Last Revised 6/9/09 American LegalNet, Inc. www.FormsWorkFlow.com CONCILIATION COURT PROCEDURES • Failure to Appear: Failure of defendant to appear at the hearing may result in a default judgment being entered for the plaintiff. Failure of the plaintiff to appear may result in dismissal of the action or a default judgment being entered in favor of the defendant on any counterclaim that has been asserted. • Questions: Visit www.mncourts.gov/district/4/?page=395 for answers to common questions about filing a claim in Hennepin County Conciliation Court. To learn how to represent yourself in a Conciliation Court case, visit www.mnmcourts.gov/selfhelp. All correspondence should be addressed to the Conciliation Court. • Continuances: The court administrator may change the date for trial if there is good cause for a continuance and a request for continuance is made at least five days (exclusive of Saturdays, Sundays and holidays) prior to trial. The court administrator may grant only one continuance per party, the maximum allowed is 30 days. A Judge must determine all other requests for continuance. All parties will be notified by the Court of any new date set for trial. The Court in its discretion may assess costs not to exceed $50.00, either absolute or conditional, to the other party as a condition of granting an order for a continuance of any case. • Counterclaims: The defendant may, if s/he has a claim against the plaintiff which is within the jurisdiction of the Court, file it with the Court not less than five days (exclusive of Saturdays, Sundays and holidays) before the trial date, upon payment of a filing fee. The Court will then notify the plaintiff of any such claim. Both the claim and counterclaim will be tried at the same time. If the counterclaim exceeds the jurisdiction limit of the Conciliation Court, see Minnesota General Rules of Practice for the District Courts, Rule 510. • Evidence: Each party should bring to the trial all witnesses and exhibits, including repair bills and estimates, deemed necessary to prove his or her case. Upon request before the trial, the Court will issue subpoenas requiring witnesses to appear. There are additional costs for issuing subpoenas and it is the responsibility of the party requesting the subpoena to have it served on the witness. • Trials: After hearing the evidence, the Judge will either make a ruling or take the case under advisement for later decision. The parties will be notified by mail of the Judge’s decision. If a party changes his or her address, the Court must be notified. • If the parties agree on a settlement prior to trial, each party who has made a claim or counterclaim shall promptly advise the Court in writing that the claim or counterclaim has been settled and that it may be dismissed. The plaintiff may notify the Court by completing the Notice of Settlement section on the claim form and mailing or bringing it to Conciliation Court. Last Revised 6/9/09 American LegalNet, Inc. www.FormsWorkFlow.com STATE OF MINNESOTA COUNTY OF HENNEPIN Plaintiff #1 FOURTH JUDICIAL DISTRICT CONCILIATION COURT The defendant(s) owe plaintiff(s) $_____________, plus a $__________ filing fee, for a total of $ ______________, plus costs, because on or about, (month and year) ______________________, ______, the following event occurred. Briefly describe the event below. Address City/State/Zip Date of Birth: Plaintiff #2 Address City/State/Zip Date of Birth: VERSUS Defendant #1 Address City/State/Zip Defendant #2 Address Under oath, I swear the above statement of claim is true and correct to the best of my knowledge, and that the person(s) being sued are at least 18 years of age, and not in the military service. City/State/Zip Defendant #3 Signed _____________________________________________________ Title of Representative: _______________________________________ Address Daytime telephone: (______)___________________________________ City/State/Zip Failure of defendant to appear at the hearing may SUBSCRIBED AND SWORN TO BEFORE ME NOTARY STAMP OR COURT SEAL result in a default judgment being entered for the plaintiff. Failure of the plaintiff to appear may result in dismissal of the action or a default Signature ____________________________________ judgment being entered in favor of the defendant Date _________________ on any counterclaim that has been asserted. OFFICE USE ONLY – DO NOT WRITE BELOW IMPORTANT NOTICE TO THE PARTIES You are hereby summoned to appear at the hearing of the above entitled case at : Minneapolis - Room 320 City Hall – 350 South 5th St, Mpls MN 55415 – 612/348-2713 Minneapolis - Room 314 City Hall – 350 South 5th St, Mpls MN 55415 – 612/348-2713 TIME: ____________________________________ AM/PM DATE: ___________________________________________ Certified Secretary of State Other _________________ SPECIAL SERVICE Returned __________ Personal Service Returned __________ Out of State – Indiv Returned __________ Returned __________ Returned __________ Notice of Settlement The above-entitled case having been settled, the same may be and hereby is dismissed with my consent. Date: __________________ Last Revised 6/9/09 _____________________________________________ Plaintiff’s Signature American LegalNet, Inc. www.FormsWorkFlow.com